Lethargy and Poor Responsiveness in a Febrile Child
A drowsy, hard-to-wake child needs urgent attention.
- Floppy tone: Key sign (reduced muscle response)
- Absent: Eye contact (no tracking or fixing)
- Delayed: Wake test (slow to rouse)
- Urgent: Action (seek care promptly)
Recognizing lethargy at the bedside
Short placeholder note on lethargy assessment steps.
Placeholder: persistent lethargy overrides normal fever reassurance.
Petechial and Purpuric Rash Warning Signs
Non-blanching spots are a classic sepsis red flag.
- Glass test: Test (spots do not fade)
- Red/purple: Color (pinpoint to patches)
- Meningococcus: Cause link (possible sepsis)
- Emergency: Action (call ambulance)
Checking for non-blanching rash
Short placeholder note on tumbler/glass test method.
Placeholder: any non-blanching rash with fever is an emergency.
Labored or Rapid Breathing Assessment
Fast breathing or chest retractions signal respiratory distress.
- Grunting: Sign (audible on exhale)
- Chest wall: Retractions (pulling inward)
- Elevated: Rate (age-adjusted threshold)
- Urgent: Action (assess oxygenation)
Spotting respiratory distress
Short placeholder note on breathing rate observation.
Placeholder: labored breathing needs prompt clinical review.
Dehydration Signs Assessment in Febrile Children
Dry mouth and sunken eyes indicate fluid loss needing care.
- Dry: Mouth (reduced saliva)
- Sunken: Eyes (orbital hollowing)
- Reduced: Nappies (fewer wet changes)
- Monitor/urgent: Action (depends on severity)
Evaluating hydration status
Short placeholder note on dehydration checklist items.
Placeholder: moderate-severe dehydration warrants prompt review.
Emergency vs Routine Care Decision Pathway
Combine flags and age to route to the right level of care.
- Home care: Flags 0 (monitor and reassess)
- GP review: Flags 1-2 (within 24 hours)
- Urgent/ER: Flags 3+ (seek prompt care)
- Always urgent: Infant <3mo (lower threshold)
Deciding the care pathway
Short placeholder note on combining flags with age risk.
Placeholder: when unsure, err toward urgent medical review.